The fundal massage is an important part of postpartum care that helps to reduce the risk of postpartum bleeding and to help the uterus shrink back to its pre-pregnancy size. It involves placing a hand on the woman's lower abdomen and stimulating the uterus using repetitive massaging or compressing movements. The massage causes the uterus to contract and squeeze downward to stop bleeding from the wound inside the uterus where the placenta was located. It is usually done soon after birth and may continue for hours or days depending on the patient's needs.
In severe cases, the massage is done with one hand on the vagina to prevent the uterus from inverting and to apply pressure to the “wound” where the placenta broke away from the uterine wall. The effectiveness of uterine massage combined with the administration of oxytocin (pitocin) has been shown to reduce blood loss in postpartum mothers. There was no additional benefit of uterine massage plus oxytocin other than oxytocin alone in terms of blood loss greater than or equal to 500 ml. After the second hour of birth, the fundus muscle massage will generally be done every 4 to 8 hours until you are discharged from the hospital.
Uterine massage can be a powerful tool for reducing postpartum hemorrhage (PPH) and maternal mortality in low-resource settings. A trial recruited 1964 women in Egypt and South Africa, but more trials with a sufficient number of women are needed to estimate the effects of sustained uterine massage. I encourage you to find out what is routine in your hospital and if background massage is your usual practice. Although a fundus massage can cause a mother a lot of discomfort, it can be an empowering experience that can change lives for the better.